"Shift goes to the lowest bidder..."

[fab4fan]

This is NOT an advertisement; it is a copy of an article. Maybe it's just me, but I find it disgusting:

---------------------------------------------------------------------------------

Online Shift Auction by Charles Townson and Catherine Whelchel April 2003 - Healthcare Information Many people today are eBay junkies, hooked on bidding and buying from home. We decided to use the same approach, in reverse, to help with nurse staffing at Spartanburg (S.C.) Regional Healthcare System.

Our information systems department set up a Web site where nurses can bid to work certain shifts. But in this case, the lowest bidder wins. For example, an employee might bid $40/hour to work an emergency department night shift. The next employee might bid $38/hour, and so on until the auction ends. The low bidder gets extra income and the healthcare system reaps benefits as well.

Online auctioning gives nurses options, flexibility and scheduling control, enabling them to choose desired shifts and work locations. Some of our nurses were doing extra shifts at other hospitals, and we wanted to give them the extra hours at their own facility while also covering shifts previously covered by agency nurses. Having our own nurses cover additional shifts would ensure a level of dedication and efficiency that could not be achieved with contract nurses.

Key players in planning the site were the system webmaster and nurse staffing coordinator for the internal float pool, with assistance from human resources and accounting. Guidelines were set to ensure that nurses would be qualified for the areas they bid on. The staffing coordinator placed some bids to test the site and resolve problems. Within weeks, the site was ready for use.

Pilot testing was set so only PRN (as-needed) RNs could bid, simplifying payroll issues during the trial period. At first, most shifts sold at the opening bid. In the first two months, only 12 shifts were bid on. But through word of mouth, our organization newsletter and letters to RNs homes, interest grew. Now, with the site in place for more than six months, 35 shifts have been put up for bid in a single week, with up to 10 bids on a shift.

After completion of the pilot phase, the site was opened to full and part-time RNs, and more than 150 have applied to use it. Another hospital in the system has also begun to use the application.

To use the site, nurses must have completed orientation and may not be under any disciplinary action or probation. Logins and passwords cannot be shared. Passwords are program-generated only after a completed online application is approved.

The auction is accessible at Spartanburg's site (http://www.spartanburgregional.com/employment/auction.htm). For the time being, employees cannot place bids while at work inside the system. They must have a unique e-mail address outside the system, which may be a limiting factor for nurses who do not have Internet capabilities at home.

The site is very easy to use. Nurses can search for open shifts by date or work area. The opening bid is set to less than what the hospital would pay to a nursing agency but in the range of what an agency would pay so we can compete with agencies while eliminating associated overhead costs. Rates are set in 50-cent increments to eliminate penny-by-penny bids.

Shifts appear on the site 17 days in advance. The winner is notified electronically 72 hours before the shift. Nurse managers may check to see if there is a bid for a given shift but, because of system security, cannot tell who has bid. At present, winners must call the staffing office to confirm the shift.

The site does not integrate with hospital systems, so payroll remains a manual check-request process since every rate is different. Personnel who oversee the site each day perform this check-and-balance procedure. As the site becomes more active, automatic feed into the payroll system will become a necessity. The positives far outweigh the costs of establishing and maintaining the auction site. More shifts are covered internally, by personnel who have a working relationship with the healthcare system. The site keeps technically savvy nurses engaged, and we hope that visiting the auction site will become part of their routine. Nurses can make extra money at a competitive rate and can schedule their time in advance.

We are considering adding LPNs and other positions to the auction site, and ancillary departments with staffing shortages, such as respiratory therapy and radiology, are also interested in trying out the system. The site has truly provided an innovative solution to our staffing complexities. It is a win-win-win situation: patients receive care, nurses have choices and the organizations saves agency expenditures. Charles Townson is chief operating officer and Catherine Whelchel is chief nursing officer, Spartanburg Regional Healthcare System, Spartanburg, S.C.

Copyright © 2003. The McGraw-Hill Companies. All Rights Reserved

[teeituptom, BSN, RN]

Granted it may be disgusting, but whoever came up with it might be seen as being shrewd.

[canoehead, BSN, RN]

It actually takes the money spent on nurses outside of an organization and gives nurses that are committed to staying with the hospital a chance to get extra money for picking up extra responsibility. If they expanded it to include holidays and summer vacation it could eliminate disputes over who would get what time off. Could also give them good evidence that pay raises across the board would be a good idea if they have people not taking FT positions so they make more money in the bidding pool.

I think there are some positives.

[fab4fan]

Whatever...I guess I have a hard time imagining locum tenens docs, or CEO's or nursing execs. being pleased in their work were handled in the same way.

[canoehead, BSN, RN]

But...they don't have agency nurses taking 25% of their shifts and getting paid twice the money for the same job.

And aren't locum tenums pretty much chosen the same way, they look for the skill mix they want and then choose the lowest bidder with the best skills? Salaried-same thing, just a longer "shift"

[fab4fan]

Well, I guess I am being overlysensitive, because to me the inherent dangers in this practice are obvious.

If other people want to sell their skills on the cheap, that's their right, I guess.

[canoehead, BSN, RN]

Yep, there's good and bad in every idea. I would hope that the nurses involved wouldn't go below their regular hourly rate. Probably it would backfire if used in an area without a shortage.

[mattsmom81]

Hospitals I've been affiliated with will go for the cheapest help possible and only laws stop them. As long as they have one or two competent RN's willing to accept charge in an unsafe unit, they will squeak by and hire cheaper help, expect the charge nurse to train, supervise, etc. I see more and more warm bodies...less competent people...but the hospital saves a buck and the manager gets a big bonus.

Nothing hospitals do today when it comes to $$ surprises me. Yes I'm cynical ...been in this game too long I guess....LOL.

I see it in subtler ways too...like letting fulltime LPN's work 60 hr weeks while PRN RN staff gets put on call. So..when they lose all their PRN staff and have to cover with high dollar agency, staff and managers complain...about a problem they caused in the first place IMO.

[Furball]

I worked at a place like this.....most of the nurses just made pact not to bid under a certain amount and everyone was making lots of extra money. It really worked!

[fergus51]

I think it would be fine if they were offering the shifts to staff nurses at the same rate as agency. What I don't like is the cheapest nurse gets it mentality. I don't think it's professional or a good idea.

[timoune1995]

i also work where there is a severe shortage of regular staff. we have 60% agency and no signs of hiring. the reg staff is getting bumped for agency, and we have to fight to get ot. now, i don't have problems with agency, but wouldn't you think that they'd Want reg staff there most of the time?

[llg, PhD, RN]

I don't think it is such a bad idea. As nurses, we have a product to sell in the marketplace (our nursing skills). Just as we are free to act as "sellers" in the marketplace by choosing to work for the place that offers us the best deal -- employers are free to act as "buyers" and choose to purchase the product at the best price.

It's not fair to say that nurses can act as "sellers" without also giving employers the right to act as "buyers." Capitalism and a free market system work both ways.

llg